PDF(Pubmed)
Abstract：
Inflammatory Bowel Diseases had their first peak in incidence in countries in North America, Europe, and Oceania and are currently experiencing a new acceleration in incidence, especially in Latin America and Asia. Despite technological advances, 90 years after the development of the first molecule for the treatment of IBD, we still do not have drugs that promote disease remission in a generalized way. We carried out a narrative review on therapeutic advances in the treatment of IBD, the mechanisms of action, and the challenges facing the therapeutic goals in the treatment of IBD. Salicylates are still used in the treatment of Ulcerative Colitis. Corticosteroids have an indication restricted to the period of therapeutic induction due to frequent adverse events, while technologies with less systemic action have been developed. Most immunomodulators showed a late onset of action, requiring a differentiated initial strategy to control the disease. New therapeutic perspectives emerged with biological therapy, initially with anti-TNF, followed by anti-integrins and anti-interleukins. Despite the different mechanisms of action, there are similarities between the general rates of effectiveness. These similar results were also evidenced in JAK inhibitors and S1p modulators, the last therapeutic classes approved for the treatment of IBD.
摘要：
炎症性肠病在北美国家/地区的发病率达到了第一个高峰，欧洲,和大洋洲，目前正在经历新的发病率加速，尤其是在拉丁美洲和亚洲。尽管技术进步,第一个治疗IBD的分子开发90年后，我们仍然没有药物，促进疾病缓解在一个普遍的方式。我们对IBD的治疗进展进行了叙述性回顾，行动机制,以及IBD治疗目标面临的挑战。水杨酸盐仍用于治疗溃疡性结肠炎。由于频繁的不良事件，皮质类固醇的适应症仅限于治疗诱导期。虽然系统作用较少的技术已经开发出来。大多数免疫调节剂表现出迟发性的作用，需要有区别的初始策略来控制疾病。生物疗法出现了新的治疗观点，最初使用抗TNF，其次是抗整合素和抗白细胞介素。尽管有不同的作用机制，一般有效率之间有相似之处。这些类似的结果也在JAK抑制剂和S1p调节剂中得到证明。最后批准用于治疗IBD的治疗类别。
